Guidelines Are Needed In Treating Labor Pains

Published: March 19, 1992

To the Editor:

Your March 6 front-page report on recommendations for pain-care management by the Agency for Health Care Policy and Research addresses the common problem of inadequate pain control in medical settings. But you do not discuss what is probably the most common and severe pain patients endured -- labor.

There is an obvious disparity in the approach of obstetricians to this problem, ranging from absolute withholding of analgesics to open advocacy of spinal anesthesia.

With so wide a variation in the clinical approach to a severe pain syndrome that affects millions of American women each year, the Agency for Health Care Policy and Research should make the dissemination of data and promulgation of guidelines on this subject a national priority. CAROLYN J. DOUGLAS, M.D. JONATHAN L. JACOBS, M.D. New York, March 8, 1992